Abstract

Background: Caring for a child with cancer significantly impacts parents' psychological well-being [1]. Following diagnosis, parents face substantial adjustment challenges with high rates of depression, anxiety, and post-traumatic stress [2]. Although parents report extensive unmet supportive care needs, few effective approaches exist. Parental resilience, a modifiable determinant, can improve parental psychological well-being, parenting, and indirectly, child outcomes [3]. However, no rigorously developed, theory-based intervention targeting parental resilience exists in mainland China.

Objective: To develop and evaluate a parent-focused, resilience-based intervention (face-to-face or online) for Chinese parents of children aged 7-14 years newly diagnosed with childhood cancer, guided by the UK Medical Research Council framework.

Methods: Four sequential phases will be conducted: Phase 1: qualitative interview study (n=30) to identify parenting challenges and resilience resources have been conducted, and results showed that parents experienced emotional distress and psychological adaptation, parenting role changes and overwhelming responsibilities, and other seven topics [4]; Phase 2: intervention development integrating our previous systematic-review evidence [5], qualitative data, and Kumpfer's Resilience Framework, with expert content validation; Phase 3: two-arm, assessor-blinded pilot randomized controlled trial (n=40) to assess feasibility, acceptability, and estimate preliminary effects, which is ongoing; Phase 4: full-scale, stratified, randomized controlled trial (n=144, 1:1) with assessments at baseline, 8 weeks, and 6 months. The primary outcome is parental resilience (measured using 11-item Resilience Scale for Adults); secondary outcomes are parental depressive and anxiety symptoms, stress, quality of life, parenting self-efficacy, and child outcomes, such as child adjustment, and quality of life. Fidelity procedures, an attention-matched control, blinding indices, and hierarchical multiple testing are prespecified. Ethical approval has been granted by the Joint CUHK–NTEC CREC and participating hospitals; the trial is registered with ChiCTR (ChiCTR2300075823).

Conclusion: This will be the first adequately powered, theory-driven trial in China evaluating whether enhancing parental resilience improves parental and child psychosocial outcomes early in the cancer trajectory, informing integration of resilience programs into pediatric oncology care.

Notes

References:

1. Michel, G., Brinkman, T. M., Wakefield, C. E., & Grootenhuis, M. (2020). Psychological Outcomes, Health-Related Quality of Life, and Neurocognitive Functioning in Survivors of Childhood Cancer and Their Parents. Pediatric clinics of North America, 67(6), 1103-1134.

2. Chen, H., He, Q., Zeng, Y., Wang, L., Yu, H., Yin, W., Jiang, Y., & Liu, L. (2022). Feeling like the sky is falling down: Experiences of parents of adolescents diagnosed with cancer in one-child families in China - A qualitative study. Journal of Clinical Nursing, 31(5-6), 733-743.

3. Li, W. H. C., Luo, Y. H., Cheung, A. T., Ho, L. K., & Chung, J. O. K. (2022). Paving the way to promote resilience in children with cancer and their families to overcome stress and adversity. Cancer Nursing, 45(1), 83. https://doi.org/10.1097/NCC.0000000000001033

4. Shao, Yuna et al. “The Effects of Psychological Interventions on Fostering Resilience in Family Members of Pediatric Cancer Patients: A Systematic Review and Meta-analysis.” Cancer nursing vol. 48,6 (2025): 490-500. doi:10.1097/NCC.0000000000001368

5. Shao, Y. N., He, W. J. A., Li, W. H. C. (2025) Experiences and needs of parenting a child with newly diagnosed cancer in China: A qualitative interpretive description study. Cancer Nursing, 48(5S):p S1-S50, 9/10

Description

This presentation describes a four-phase randomized controlled trial developing and testing a theory-driven, culturally sensitive resilience-focused parenting program for Chinese families of children newly diagnosed with cancer. Participants will learn about the systematic development process guided by the UK MRC framework, preliminary findings, and implications for integrating evidence-based resilience programs into pediatric oncology care to improve parental and child psychosocial outcomes.

Author Details

Yuna Shao, MPhil; 

Ting Zhong, MSN; 

Aaron Wan Jia He, PhD, MPT;

Professor William Ho Cheung Li, PhD;

Li Zhou, MSN;

Ziqin Lin, BSN

Sigma Membership

Non-member

Type

Poster

Format Type

Text-based Document

Study Design/Type

Randomized Controlled Trial

Research Approach

Quantitative Research

Keywords:

Academic-Clinical Partnership, Implementation Science, Childhood Cancer, Childhood Neoplasms, Parents, Resilience, Hardiness

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-29

Click on the above link to access the poster.

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Effects of a Resilience-Focused Parenting Program in Childhood Cancer: A Randomized Controlled Trial

Toronto, Ontario, Canada

Background: Caring for a child with cancer significantly impacts parents' psychological well-being [1]. Following diagnosis, parents face substantial adjustment challenges with high rates of depression, anxiety, and post-traumatic stress [2]. Although parents report extensive unmet supportive care needs, few effective approaches exist. Parental resilience, a modifiable determinant, can improve parental psychological well-being, parenting, and indirectly, child outcomes [3]. However, no rigorously developed, theory-based intervention targeting parental resilience exists in mainland China.

Objective: To develop and evaluate a parent-focused, resilience-based intervention (face-to-face or online) for Chinese parents of children aged 7-14 years newly diagnosed with childhood cancer, guided by the UK Medical Research Council framework.

Methods: Four sequential phases will be conducted: Phase 1: qualitative interview study (n=30) to identify parenting challenges and resilience resources have been conducted, and results showed that parents experienced emotional distress and psychological adaptation, parenting role changes and overwhelming responsibilities, and other seven topics [4]; Phase 2: intervention development integrating our previous systematic-review evidence [5], qualitative data, and Kumpfer's Resilience Framework, with expert content validation; Phase 3: two-arm, assessor-blinded pilot randomized controlled trial (n=40) to assess feasibility, acceptability, and estimate preliminary effects, which is ongoing; Phase 4: full-scale, stratified, randomized controlled trial (n=144, 1:1) with assessments at baseline, 8 weeks, and 6 months. The primary outcome is parental resilience (measured using 11-item Resilience Scale for Adults); secondary outcomes are parental depressive and anxiety symptoms, stress, quality of life, parenting self-efficacy, and child outcomes, such as child adjustment, and quality of life. Fidelity procedures, an attention-matched control, blinding indices, and hierarchical multiple testing are prespecified. Ethical approval has been granted by the Joint CUHK–NTEC CREC and participating hospitals; the trial is registered with ChiCTR (ChiCTR2300075823).

Conclusion: This will be the first adequately powered, theory-driven trial in China evaluating whether enhancing parental resilience improves parental and child psychosocial outcomes early in the cancer trajectory, informing integration of resilience programs into pediatric oncology care.